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Clinicians have considered using glycated proteins such as fructosamine, glycated albumin, and advanced glycation end products as supplemental markers to HbA1c to measure blood glucose. However, as the program summary explains, laboratorians know little about these analytics.

Measurement of fructosamine and glycated albumin assays face some challenges, at least with respect to their use in routine clinical practice. Fructosamine in particular measures all proteins, including globulins “and thus can be affected by conditions in which albumin or globulin are altered,” Cyrus Desouza, MD, a professor of internal medicine and endocrinology at the University of Nebraska Medical Center and one of the session’s speakers, told CLN Stat.

Reducing substances such as bilirubin and certain types of vitamins can affect both fructosamine and glycated albumin assays, Desouza said. Neither has been well-standardized in the United States and, as a result, neither is reliable as an absolute value. However, they do serve some value in measuring patterns of change, he said.

Desouza plans to discuss the clinical utility of fructosamine and glycated albumin in conditions for which HbA1c is unreliable, such as chronic kidney disease, glycemic variations, short-term glucose control and pregnancy.

David Sacks, MD, MB, ChB, FRCPath, chief of the clinical chemistry service at the National Institutes of Health’s department of laboratory medicine, and Paul Thornalley, PhD, professor in systems biology at the University of Warwick in Coventry, England, will join Desouza on the panel.

Sacks will focus his discussion on HbA1c, fructosamine, and glycated albumin assays, and the difficulty in standardizing and adapting them for broad clinical use. Thornalley will follow up by talking about advanced glycation end products and their relationship to complications in diabetes, prediction value, and the prognosis and mechanisms that might be addressed to prevent such complications.